Safe and effective anesthesia of dogs and cats rely on preanesthetic patient assessment and preparation. Patients should be premedicated with drugs that provide sedation and analgesia prior to anesthetic induction with drugs that allow endotracheal intubation. Maintenance is typically with a volatile anesthetic such as isoflurane or sevoflurane delivered via an endotracheal tube. In addition, local anesthetic nerve blocks; epidural administration of opioids; and constant rate infusions of lidocaine, ketamine, and opioids are useful to enhance analgesia. Cardiovascular, respiratory, and central nervous system functions are continuously monitored so that anesthetic depth can be modified as needed. Emergency drugs and equipment, as well as an action plan for their use, should be available throughout the perianesthetic period. Additionally, intravenous access and crystalloid or colloids are administered to maintain circulating blood volume. Someone trained in the detection of recovery abnormalities should monitor patients throughout recovery. Postoperatively attention is given to body temperature, level of sedation, and appropriate analgesia.

Ingestion of Lilium or Hemerocallis spp. by cats can result in renal failure. The objectives of this study were to determine the foreknowledge of lily toxicity of owners of cats that were exposed to lilies and to obtain historical, clinical and outcome information on the exposures. A survey was done of cat owners reporting indoor exposures to lilies to the Animal Poison Control Center (APCC) during April 2009. Forty eight individuals, (57 cats) were included. Sixty nine percent of cat owners said they could recognize a lily and 27% knew that lilies were toxic prior to their cats’ exposures. Most lilies were obtained from grocery or other stores, and were purchased by the owners or as gifts to the cat owners. Owners who were unaware of lily toxicity frequently left the flowers where the cats had access to them, whereas in households where the toxicity was known the cats actively sought out the flowers. Of the cats in this study 93% received prompt veterinary care, and 87% either developed no signs or had brief signs that resolved. Five percent had evidence of renal insufficiency at final follow-up and another 5 percent of cats were euthanized due to renal failure.

Kidney biopsies in dogs are commonly obtained using automated spring-loaded biopsy instruments. Interpretation of biopsies from dogs with glomerular disease requires examination of at least 5–10 glomeruli, with at least two biopsies usually required for full evaluation. The purpose of this study was to compare quality and interpretability of renal biopsies obtained from healthy dogs with a large-gauge, vacuum-assisted biopsy instrument versus two biopsies obtained with a spring-loaded biopsy needle. Twenty dogs were randomized into two groups, and percutaneous, ultrasound-guided renal biopsies were evaluated using standard criteria. There were no significant differences in the number of biopsies that contained renal tissue, cortex, or medulla. Biopsies obtained with either instrument contained an adequate number of glomeruli and an equivalent number of arterioles and severity of tissue compression. Differences included easier penetration of the renal capsule and collection of sufficient tissue for interpretation with only one instrument pass when using the vacuum-assisted device (vs two passes required with the spring-loaded instrument). Before use in client-owned dogs, future studies should evaluate whether these differences are clinically relevant advantages in the diagnostic evaluation of dogs with kidney disease, and determine the prevalence and severity of complications when using this larger gauge device.

An intradermal allergy test (IDT) is an important diagnostic tool for identifying offending allergens in canine atopic dermatitis. No standardized method of scoring an IDT has been described. The purpose of this study was to determine whether there is a correlation between a conventional, subjective IDT scoring method based on perceived wheal diameter, erythema, and turgor (0–4+) and an objective scoring method based on measuring wheal diameter alone. Thirty-four atopic dogs were skin tested with 68 different allergens. All skin tests were performed according to standard procedures, and any IDT score ≥2+ was considered clinically significant. When the subjective IDT scores were compared with the objective IDT scores in all dogs, there was a moderate level of correlation overall (r=0.457; P <0.0001). The highest level of agreement between subjective and objective scores was noted with the reactions assigned subjective scores of “0” and “2+.” Overall, there was a slight level of agreement between subjective and objective scores based on clinical significance (i.e., subjective scores ≥2+; κ=0.20; P <0.0001). In conclusion, the authors believe that the objective scoring method used in this study may provide a point of reference for inexperienced individuals (dermatology residents, veterinarians, technicians) when learning to grade an IDT.

Antiseptic flushing of the canine prepuce and its exclusion from the surgical field are recommended before abdominal surgery to reduce the risk of bacterial contamination. The authors cultured the preputial cavity of 60 dogs prior to and following flushing with 0.05% chlorhexidine diacetate, 1% povidone-iodine, or 0.9% saline control. Bacterial growth was evaluated using a semiquantitative method, and bacterial organisms were subsequently identified. There were no significant differences between povidone-iodine and the saline control in any of the variables assessed. Chlorhexidine resulted in a significant decrease in the proportion of positive postflush cultures compared with povidone-iodine. Although not significant, the difference in adverse reactions between povidone-iodine (25%) and chlorhexidine diacetate (5%) suggests clinical relevance. Based on the results of this study, a 2 min flush with 0.05% chlorhexidine diacetate is recommended for presurgical preparation of the preputial cavity.

This was a retrospective case study of eight dogs diagnosed with prostatic or testicular B. dermatitidis infection. Signalment, clinical presentation, diagnostic procedures, and treatment options were evaluated. Review of medical records of dogs diagnosed with blastomycosis at the University of Illinois Veterinary Teaching Hospital from 1992 to 2005 yielded four dogs with prostatic blastomycosis (PB) and four dogs with testicular blastomycosis (TB). Three of the four dogs with PB and all four dogs with TB had evidence of urogenital disease. Three dogs with PB had an elevated body temperature and all had systemic disease. All dogs with TB had a normal body temperature, and three had systemic disease and one had clinical signs limited to testicular disease. Cytology or histopathology was used to diagnose PB or TB. Treatment included itraconazole or fluconazole with or without nonsteroidal anti-inflammatory drugs. PB and TB are infrequently recognized and may be under diagnosed due to failure to specifically evaluate these tissues. PB or TB should be considered in the evaluation and staging of male dogs with blastomycosis. Male dogs with urogenital signs should be evaluated via prostatic or testicular cytology or histopathology since proper identification and management of PB or TB may improve overall treatment success.

Ten dogs that had skin lesions as the only presenting signs of hyperadrenocorticism (HAC) and as the owners’ primary complaint are described. Dogs were included if the initial examination was for skin disease, there were no signs of systemic illness on initial presentation and there was a confirmed diagnosis of HAC by specific screening tests. Dogs were excluded if they had a severe disease that might interfere with screening tests for HAC or if the screening tests were not diagnostic. There were five males and five females; six dogs were intact. Nine dogs were diagnosed at ≥7 years. Eight dogs weighed ≤10 kg. Alopecia was present in nine dogs. Eight dogs had bacterial pyoderma, five had hyperpigmentation, and four had thin skin. One dog had unresolved dermatophytosis. Skin lesions resolved after treatment in eight dogs. One dog was not treated and one was lost to follow-up. This study showed that skin lesions may be the only clinical signs of HAC. The presence of the more common clinical signs of HAC, such as a non-pruritic, truncal alopecia and/or thin skin, without any systemic signs of HAC and/or the presence of poorly responsive skin infections warrant screening for this disease.

Sixty-one adrenal gland tumors were surgically removed from 60 dogs. Fifty-two dogs underwent elective adrenalectomy and 8 dogs underwent emergency adrenalectomy for acute adrenal hemorrhage. Size of adrenal tumors ranged from 10 mm to 80 mm. Histopathology confirmed a diagnosis of adrenocortical tumor in 47 dogs, 26 of which were malignant. Pheochromocytoma was diagnosed in 11 dogs. Six dogs had tumor invasion of the caudal vena cava. Of the seven dogs that did not survive the perioperative period, four underwent emergency adrenalectomy. No dogs with tumor invasion of the caudal vena cava died perioperatively. Perioperative morality rates were 5.7% for dogs that underwent elective adrenalectomy and 50% for dogs that underwent emergency adrenalectomy for acute adrenal hemorrhage. Median survival time was 492 days for the 53 dogs that survived the perioperative period. Of the factors analyzed, only adrenal tumor size and the presence of acute adrenal hemorrhage had predictive values for perioperative mortality. Those dogs that survived the perioperative period had extended survival times of up to 1,590 days. The mortality rate associated with elective adrenalectomy in dogs may be lower than previously reported. Dogs with very large tumors or acute adrenal hemorrhage may have a more guarded prognosis.

Two healthy cats underwent elective surgical procedures under general anesthesia. One developed severe esophagitis leading to esophageal rupture, mediastinitis, and pyothorax. The other cat developed esophageal stricture, diverticulum formation, and suspected iatrogenic perforation. Both cats had signs of dysphagia and regurgitation beginning a few days after anesthesia. The first cat also had severe dyspnea due to septic pleural effusion and pneumomediastinum. In the second cat, endoscopy revealed diffuse esophagitis, an esophageal stricture, and a large esophageal diverticulum. Rupture of the esophageal wall occurred while inflating the esophagus for inspection. Due to the poor prognosis, both cats were euthanized. Necropsy revealed severe esophageal changes. Postanesthetic esophagitis has been previously described in dogs and cats; however, severe life-threatening esophageal injuries rarely occur as a sequel to general anesthesia. To the authors’ knowledge, esophageal rupture secondary to perianesthetic reflux has never been reported in cats.

A 7 mo old Labrador retriever presented for evaluation of facial swelling associated with a 5 cm oral mass extending caudally from the upper third premolar on the left side. Cytology revealed an atypical population of round cells of undetermined origin. A diagnosis of alveolar rhabdomyosarcoma (RMS) was reached via histopathology and confirmed with positive immunohistochemical staining for desmin. In humans, RMSs have a well-described round cell cytologic appearance. Few descriptions of veterinary cases of RMS exist. This report describes the cytologic appearance of alveolar RMS in a young dog and both summarizes and compares findings throughout the veterinary and human literature.

A 9 yr old spayed female cocker spaniel presented for evaluation of an invasive maxillary squamous cell carcinoma. Curative intent surgery and radiation therapy allowed for local control of the neoplasm; however, the development of a persistent oronasal fistula prevented a complete recovery. A temporalis myofascial rotation flap allowed for successful resolution of the maxillary defect. Implementation of the flap was relatively simple and was associated with few complications.

Granulomatous sebaceous adenitis (GSA) is uncommon in dogs; however, certain breed predilections exist. In this report, three cases of GSA in unrelated vizslas have been described. All cases initially presented with episodes of otitis externa followed by severe inner pinnal lesions. In one case, multifocal coalescing inner pinnal ulceration appeared 4 wk prior to the occurrence of the skin lesions. The other two cases presented with simultaneous pinnal and skin lesions following episodes of bilateral otitis. The pinnae were diffusely erythematous and had multiple coalescing erosions and ulcers. The body lesions consisted of multifocal alopecia, papules, and fine scales. Biopsies of the skin and pinnae confirmed GSA. Two dogs responded to treatment with synthetic retinoids and cyclosporin A, respectively. One dog was not treated, and the owners preferred euthanasia when the ear lesions recurred and did not respond to glucocorticoids. To the best of the authors’ knowledge, GSA with multifocal coalescing ulcerative pinnal lesions has not previously been reported.

Eighteen clinically ill dogs, naturally infected with Anaplasma phagocytophilum, were examined at a veterinary practice in Baxter, Minnesota. A clinical examination, complete blood cell count, enzyme- linked immunosorbent assay (ELISA) for A phagocytophilum, Borrelia burgdorferi, and Ehrlichia canis antibodies and Dirofilaria immitis antigen, and a polymerase chain reaction test for A phagocytophilum DNA were obtained for all dogs. Physical examination findings included fever, arthropathy, lymphadenopathy, epistaxis, acute gastritis, cervical hyperpathia, and central nervous system dysfunction. Complete blood cell count abnormalities included thrombocytopenia, morulae in neutrophils, anemia, leukopenia, eosinopenia, lymphopenia, and monocytosis. Seroreactivity to A phagocytophilum was found in 61%, B burgdorferi antibodies in 17%, and D immitis antigen in 5% of the dogs. Fever, arthropathy, neurologic dysfunction, and epistaxis are clinical syndromes that can be associated with A phagocytophilum infection. Treatment with doxycycline resulted in rapid resolution of clinical signs in all dogs.

This is a retrospective case series consisting of five dogs diagnosed with schistosomiasis. The purpose of this article is to report the presence of naturally occurring canine schistosomiasis in Kansas and to provide clinical details regarding schistosomiasis. Medical records of dogs diagnosed with schistosomiasis from 2000 to 2009 were reviewed, and information extracted included signalment, history, clinical signs, diagnostic test results, treatment, and outcome. Affected dogs were primarily medium to large breed and young to middle aged. All dogs were considered outdoor dogs, with three having known access to surface water. Common clinical signs included gastrointestinal disease and signs associated with hypercalcemia. Fecal flotation was negative in all dogs in contrast to fecal saline sedimentation and fecal polymerase chain reaction, which were both positive in all dogs in which it was performed. All dogs treated specifically for schistosomiasis fully recovered. This article describes the first reported cases of canine schistosomiasis in the Midwest and the first reported case of intestinal intussusception secondary to schistosomiasis. Recognizing that canine schistosomiasis is present in Kansas and possibly other Midwestern states should prompt veterinarians to perform appropriate diagnostic investigation in suspect animals as the diagnosis is straight forward and relatively inexpensive.

Remifentanil is a synthetic opioid with direct action on μ opioid receptors. It has an ultrashort duration of action, and its elimination is independent of hepatic or renal function. The anesthetic management of five dogs with nonuniform liver disease and requiring liver biopsy via celiotomy is described. Remifentanil and isoflurane were used for induction and maintenance of anesthesia. Intraoperative analgesia was provided by a constant rate infusion of remifentanil. Remifentanil, in combination with isoflurane, was safely and successfully used in five cases for the balanced anesthesia of dogs with hepatic diseases requiring liver biopsy via celiotomy.

A 6 yr old, male, neutered Weimaraner was treated homeopathically for nasal aspergillosis after failing to respond to two treatments of topical (intranasal) clotrimazole and oral amoxicillin trihydrate/clavulanate potassium. Computed tomography, rhinoscopy, fungal culture, and cytology previously confirmed the diagnosis. At presentation for homeopathic treatment, the dog had aggressive left-sided sinusitis and rhinitis with destruction of nasal turbinates and severe bouts of epistaxis. Erosion and depigmentation of the nasal planum were evident. After two treatments with homeopathic aurum metallicum, resolution of clinical signs occurred and clearance of the aspergillosis organisms was documented by computed tomographic scan, rhinoscopy, and histopathology. Homeopathic aurum metallicum may be beneficial in treating cases of canine nasal aspergillosis.

A 9 yr old domestic shorthair cat was diagnosed with cutaneous and pulmonic blastomycosis. Severe persistent ionized hypercalcemia and excess circulating concentration of calcitriol were documented in association with blastomycosis. Ionized hypercalcemia resolved when the granulomatous lesions of blastomycosis resolved and the calcitriol levels decreased.

A 6 yr old domestic longhair cat was evaluated for progressive weight loss, weakness, and dyspnea. Results of a physical examination and electrocardiogram were suggestive of cardiac disease. Thoracic radiographs revealed pleural effusion, which thoracocentesis revealed was consistent with chyle. An echocardiogram was performed, and aortic valve endocarditis with secondary aortic insufficiency was presumptively diagnosed. The cat was treated with broad-spectrum oral antibiotics and palliative cardiac medications. Two days after discharge, the cat's dyspnea returned, and it died suddenly. Histopathology and culture confirmed Pseudomonas bacterial endocarditis of the aortic valve. Bacterial endocarditis in the cat has rarely been reported in the literature. This case described heart failure and chylothorax resulting from bacterial endocarditis.

A 10 yr old female cat presented for an acute onset of back arching, regurgitation, and open mouth breathing. Radiographs indicated the presence of a large intrathoracic mass. Computed tomography confirmed the presence of a large mass of fatty density in the dorso-caudal mediastinum. The mass was removed via right intercostal thoracotomy, and histopathology confirmed the mass as a lipoma. The cat was continuing to recover well as of 21 mo after surgery. This is the first reported case of an intrathoracic lipoma in a cat.

A 12 yr old male neutered domestic shorthair cat presented with worsening tachypnea of 1 mo duration and open mouth breathing. Radiographs revealed tracheal narrowing at the thoracic inlet. Computed tomography (CT) revealed a contrast enhancing 8-cm long fusiform mass within the dorsal tracheal membrane. Tracheobronchoscopy confirmed the presence of the tracheal mass at the thoracic inlet, and lymphoma was diagnosed based on uniformly atypical lymphoid cells on aspirated bronchoalveolar lavage fluid. The cat was treated with combination chemotherapy consisting of cyclophosphamide, vincristine, doxorubicin, and prednisolone. Thoracic radiographs and CT performed 1 mo after completion of the 6 mo chemotherapy protocol revealed resolution of the tracheal mass. The cat remained clinically normal at 21 mo after treatment.

A 4 yr old male castrated Labrador retriever was evaluated for a short history of inappetance, lethargy, small-bowel diarrhea, polyuria, and polydipsia. Clinicopathologic abnormalities were consistent with protein-losing nephropathy and renal azotemia. Expansive infectious disease testing implicated Babesia gibsoni via whole blood polymerase chain reaction. Renal histopathology results were consistent with membranoproliferative glomerulonephritis and immune complex deposition. The dog was treated with azithromycin, atovaquone, and one dose of corticosteroids/cyclophosphamide. Three months after therapy was completed, the dog was clinically healthy, and all clinicopathologic abnormalities (including Babesia species polymerase chain reaction) had resolved. Atypical presentations of Babesia gibsoni should be considered with proteinuric nephropathy.

A 5 yr old female spayed mastiff was evaluated for a 3–4 mo history of paraparesis and 3 days of acutely worse paraparesis and incontinence. On magnetic resonance imaging, a spinal cord lesion was present at the ninth thoracic vertebra. The lesion was hyperintense on T2-weighted images (T2-W), and a hyperintense rim was present on T1-weighted postcontrast images. Histologic examination showed a cystic mass lined by squamous epithelial cells. Histopathologic diagnosis was an intramedullary epidermoid spinal cyst. Epidermoid cyst should be a differential diagnosis in young dogs with a myelopathy and an intramedullary spinal cord lesion on magnetic resonance imaging examination.

An 8 wk old Scottish terrier was evaluated for a 2×2 cm mass located directly adjacent to the lateral canthus of the right eye. Examination revealed a well-developed Cuterebra larva at the lateral aspect of the orbital cavity, anchored at the lateral canthus. The larva was manually removed under general anesthesia, and the eyelid margin was repaired. Systemic and topical antibiotics along with systemic anti-inflammatory treatment were instituted. The lesion healed completely, revealing a normal functional right eye 10 days after removal of the Cuterebra larva. Careful manual removal of the larva is recommended along with correction of any resultant conformational defects. The remaining cavity can be left to heal; however, antibiotic therapy is recommended.

A 7 mo old intact female golden retriever was evaluated for acute vomiting. Abdominal radiographs revealed a possible gastric foreign body. Upper gastrointestinal endoscopy revealed an edematous, tubular antral mass, which on further evaluation was determined to be a pylorogastric intussusception based on radiographic, endoscopic, and surgical findings. Spontaneous resolution of the intussusception occurred upon surgical exploration of the abdomen. Histopathology of a full-thickness gastric biopsy revealed vascular congestion consistent with an intussusception, but did not indicate the primary cause. The dog recovered uneventfully from surgery and had no further vomiting during the 6 mo follow-up period. This case was significant as it was the first report of pylorogastric intussusception diagnosed using endoscopy. This description of the unique endoscopic appearance of pylorogastric intussusception will be useful for the veterinary endoscopist.

A 7 yr old castrated male Australian shepherd dog was examined for acute change in iris color, lethargy, and anorexia. Uveitis, acute renal failure, and presumed cholecystitis were diagnosed. Based on clinical findings, leptosporosis was suspected, and the dog was treated with antibiotics and supportive care. The dog made a complete recovery, and leptospirosis was confirmed on convalescent titers. Due to the zoonotic potential, leptospirosis should be considered in cases of uveitis, as well as possible cholecystitis.

An adult castrated male cat was evaluated because of a 4 day history of lethargy and partial anorexia. Physical examination revealed abdominal pain with a palpable fluid wave. Cytologic and biochemical analyses of peritoneal effusion were suggestive of septic peritonitis. On surgical exploration of the abdomen, the mesenteric vessels had no palpable pulses and they contained gross thromboses. The intestines were white with no visible peristalsis. Necropsy findings included disseminated, poorly differentiated hemangiosarcoma throughout the abdomen. Mesenteric arterioles contained fibrin thrombi. To the author's knowledge, no previous reports exist of complete mesenteric vascular thrombosis associated with disseminated abdominal visceral hemangiosarcoma in a cat.

A 9 yr old neutered male mixed-breed dog was presented for an anal sac apocrine gland adenocarcinoma with regional nodal metastases. At presentation, ionized calcium was 1.91 mmol/L (NOVA Stat reference range, 1.1–1.3 mmol/L). Surgical excision of the primary tumor and metastatic lymph nodes was performed. Following surgery, symptomatic hypocalcemia was noted. Repeated ionized calcium measurements confirmed hypocalcemia, and hypercalcemia of malignancy panels suggested parathyroid gland suppression as the cause. The calcium normalized with parenteral calcium administration, but calcium later became elevated with tumor recurrence and an increase in the parathormone-related peptide. Disrupted calcium homeostasis is a potential complication following the treatment of long-standing humoral hypercalcemia of malignancy.

Four small-breed dogs were diagnosed with acquired Fanconi syndrome. All dogs ate varying amounts of chicken jerky treats. All dogs were examined for similar clinical signs that included, but were not limited to, lethargy, vomiting, anorexia, diarrhea, and altered thirst and urination. The quantity of chicken jerky consumed could not be determined; however, based on the histories obtained, the chicken jerky treats were a significant part of the diet and were consumed daily by all dogs. Extensive diagnostic testing eliminated other causes of the observed clinical signs, such as urinary tract infection and rickettsial disease. Glucosuria in the face of euglycemia or hypoglycemia, aminoaciduria, and metabolic acidosis confirmed the diagnosis of Fanconi syndrome. All dogs received supportive care, including IV fluids, antibiotics, gastroprotectants, and oral nutritional supplements. Three dogs exhibited complete resolution of glucosuria, proteinuria, and the associated azotemia; however, one dog remained azotemic, resulting in a diagnosis of chronic kidney disease.

A 12 yr old castrated male Yorkshire terrier was presented with a history of an inoperable pheochromocytoma. Physical examination revealed a large, midabdominal mass. Neurologic examination was normal at presentation. An abdominal computed tomography scan revealed a 215 cm³ mass in the region of the right kidney. Forty-eight hours after IV injection of 370 megabecquerels (MBq, equivalent to10 millicuries [mCi]) of metaiodobenzylguanidine labeled with radioactive iodine ([¹³¹I]MIBG), standard planar scintigraphy was performed. A diffuse area of moderate uptake was noted in the midabdominal region. The dog experienced stable disease for 1.5 mo after injection based on a follow-up computed tomography (CT) scan; however, 5 mo after injection, repeat CT imaging revealed progression of the tumor, and a second IV injection of 370 MBq (10 mCi) of [¹³¹I]MIBG was administered. The dog died 3 wk after the second injection as a result of gastrointestinal blood loss that was believed to be caused by compression-induced bowel ischemia by the mass. A full necropsy was not performed, but the mass was removed for histologic evaluation, which confirmed the diagnosis of pheochromocytoma. This report is the first to document the treatment of canine pheochromocytoma using [¹³¹I]MIBG.

Two castrated male dogs presented for evaluation of tenesmus. Presurgical evaluations included complete physical examinations, serum biochemistry, abdominal ultrasonography, and MRI (case 2 only). Paraprostatic cysts were diagnosed in both cases based on the results of abdominal ultrasonography, MRI, and histopathology of tissue samples obtained during exploratory laparotomy. To the authors' knowledge, the two cases presented herein are the first documented cases of paraprostatic cysts that developed after castration in male dogs. Paraprostatic cysts should be considered in the differential diagnoses for castrated male dogs with prostatic disease.

Eight animals underwent fusion podoplasties for the treatment of chronic interdigital furunculosis (n=3), ectrodactyly (n=1), digit abnormalities associated with tendonectomy (n=1), redundant indertigital skin (n=1), conformational deformity (n=1), and necrotizing fasciitis of the paw (n=1). Median duration of bandaging was 14 days, and median duration of hospitalization was 5 days. Four dogs had dehiscence, which occurred at a mean time of 11 days after surgery. Clinical abnormalities necessitating podoplasty resolved in six animals and improved in two. Six animals had normal ambulation and two dogs had slight weight-bearing lameness after a median follow-up time of 29 mo. Fusion podoplasty may be recommended as a salvage procedure for the treatment of various chronic pedal diseases in dogs and cats.